Individual
DR. MARIO NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 WOODS RD, VALHALLA, NY 10595-1530
(914) 493-8051
(914) 493-7637
Mailing address
100 WOODS RD, VALHALLA, NY 10595-1530
(914) 493-8051
(914) 493-7637
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
163147
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00911046
—
NY
01
—
163147
LICENSE
—
Enumeration date
12/01/2005
Last updated
12/16/2015
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